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Wisconsin rates for HCPCS 58573

Laparoscopy Tot Hysterectomy >250 G W/Tube/Ovar

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,303.95 / $9,580.00 / $28,479.22
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$10,878.00 / $15,141.00 / $22,609.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,154.46 / $1,752.84 / $1,752.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,114.27 / $3,639.27 / $5,870.02
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,203.29 / $1,471.60 / $3,695.14
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,303.95 / $8,791.00 / $17,200.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,203.29 / $1,471.60 / $3,695.14
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,384.19 / $3,668.00 / $4,336.68
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$27,770.10 / $27,770.10 / $27,770.10
Quartz
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$2,632.21 / $2,632.21 / $2,632.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,627.00 / $12,373.00 / $15,090.00